EP0316371B1 - Device for adjusting a vertebral column - Google Patents

Device for adjusting a vertebral column Download PDF

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Publication number
EP0316371B1
EP0316371B1 EP88902804A EP88902804A EP0316371B1 EP 0316371 B1 EP0316371 B1 EP 0316371B1 EP 88902804 A EP88902804 A EP 88902804A EP 88902804 A EP88902804 A EP 88902804A EP 0316371 B1 EP0316371 B1 EP 0316371B1
Authority
EP
European Patent Office
Prior art keywords
displays
extension rod
fixing
piece
arm
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
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EP88902804A
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German (de)
French (fr)
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EP0316371A1 (en
Inventor
Patrick Dr. Med. Kluger
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Ulrich GmbH and Co KG
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Individual
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Publication of EP0316371A1 publication Critical patent/EP0316371A1/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7014—Longitudinal elements, e.g. rods with means for adjusting the distance between two screws or hooks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7007—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0256—Joint distractors for the spine

Definitions

  • the invention relates to a device for setting up a spine with damaged vertebral bodies, consisting of an arm adjustable on a guide axis and a fixed arm arranged thereon, each arm carrying a hollow body, adjustable in two planes, for an extension rod, which can be connected with a bone screw.
  • Such a device is known from EP-A-0159007.
  • the arms arranged on the guide axis are spatially curved, and at the end they are articulated threaded pins, on which a receiving sleeve can be rotated and locked with the aid of a wing nut.
  • the design of the device in this way in particular the arrangement of the receiving sleeve and its attachment, does not meet the requirements that an operator must place on such a device, particularly with regard to easy handling.
  • the invention is therefore based on the object of improving the device for setting up a spine with damaged vertebral bodies in such a way that easier handling is achieved.
  • each arm carries an intermediate joint piece with two joints, wherein a support for the receiving hollow body is articulated on the intermediate joint piece, which is designed as a fixable cylinder piece with a bore that is at a radial distance and perpendicular to the cylinder piece longitudinal axis plane is arranged.
  • a fixing screw for fixing the extension rod is provided at an acute angle to the bore.
  • the cylinder piece is axially adjustable and lockable in one end position.
  • the carrier carries a vertical threaded pin which has a grid plate at one end and a nut rotatable on the thread at a distance therefrom, the hollow receptacle body being rotatably and axially adjustable between the nut and the grid plate.
  • the extension rod can be inserted and fixed more easily and more easily in the receiving hollow body by axially displacing the cylinder piece by means of the nut, the grid plate being gripped so that on the one hand the catches of the grid plate and on the other hand the catches of the cylinder piece are engaged .
  • the fixing screw for fixing the extension rod is easier to operate by the surgeon due to its inclined position.
  • the arrangement of the intermediate joint pieces makes it easier to set up the entire device.
  • the extension rod has at the end a trough-shaped design for receiving the bone screw, which has a correspondingly designed profile piece with a grid for receiving a fixing rod on the head side.
  • the trough-shaped design has more than a semicircular shape, so that the extension rod can only be pulled out axially.
  • the bone screw in the trough-shaped configuration is fastened by a screw which can be screwed in at an acute angle to the axis of the extension rod, so that here too the operator can handle the device more easily.
  • connection of the bone screw with the extension rod can consist in that a cylindrical roller piece is arranged on the bone screw, which has a raster for receiving a fixing rod at the end, the extension rod then having a fork piece corresponding to the cylinder shape at the end, so that this extension rod can be pushed onto the roller piece.
  • the extension rod is rotatably connected to the roller piece, for example, in that an attachment is attached to the roller piece, which engages in a corresponding recess in the fork piece of the extension rod.
  • a particularly expedient embodiment of the fixing rod consists in that the fixing rod is formed from telescopic pieces, the insertable part of which has fixing notches, this fixing rod also having a grid plate with a bore at the end.
  • this fixing rod serves to fix the vertebral bodies that have been set up with the aid of the device, so that the damaged vertebral area is bridged by the fixing rod.
  • the length of the fixing rod and also the relative position of the end grid plates to each other is then fixed in such a way that the outer telescopic piece is pressed in with the aid of a perforated template with the aid of appropriately trained pliers, this notch then lying exactly in the notch of the telescopic piece that can be inserted .
  • a one-piece fixing rod with a grid plate at the end with a hole is provided.
  • the device for setting up a spine consists of the guide axis 1 and the arm 2 fixedly arranged thereon and the arm 4 which can be moved or adjusted with the aid of a threaded spindle 3.
  • Each arm 2 or 4 carries an intermediate joint piece 5 or 5a with the joint axes 6 and 7.
  • a carrier 8 or 8a is articulated to the intermediate joint piece 5 or 5a, which carries the receiving hollow body 9, which is designated overall by 9.
  • the adjustment plane of the receiving hollow body is perpendicular to the adjustment plane of the carrier 8 or 8a.
  • FIG. 2 The design of the receiving hollow body 9 is shown in detail in FIG. 2.
  • a vertical threaded pin 10 is arranged on the arm 8, which carries the thread 11 in the lower part.
  • the grid plate 12, which has the catches 13, is fixedly arranged at one end of the threaded pin.
  • the nut 14 is arranged.
  • the receiving hollow body designed as a cylinder piece 15, which has the bore 16 arranged at a radial distance and perpendicular to the longitudinal axis plane of the cylinder piece, is axially adjustable and fixable in an end position. If the nut 14 is rotated, then the cylinder piece 15 moves towards the grid plate, the catches on the one hand on the grid plate, namely the catches 13 engaging with the catches 13a on the cylinder piece.
  • the bore 16 receives the extension rod 17.
  • the extension rod 17 is fastened with the aid of a fixing screw 18, which is arranged at an acute angle to the tangential bore 16.
  • This design of the receiving hollow body as a fixable cylinder piece with a tangential bore makes the device easier to use because the parts to be used and the parts to be locked are easily accessible.
  • any position of the extension piece can be adjusted by the intermediate joint piece 5 or 5a and the adjustability of the cylinder piece on the threaded pin 10, as a result of which the extension rods 17, 17a placed on the bone screw 19 can also be set up accordingly, which means that the device in FIG the healthy vertebrae screwed in.
  • extension rod and the associated bone screw also represent an improvement in the handling of the device by the surgeon.
  • the extension rod has a trough-shaped design 20 at the end, which is received by the bone screw 19.
  • the bone screw has a correspondingly designed profile piece 21 on the head side with a raster 22 arranged on the top.
  • the profile piece 21 is also fastened in the trough-shaped configuration 20 with a screw 23, which runs at an acute angle to the axis of the extension rod 17 (FIG. 1).
  • the trough-shaped design 20 has more than a semicircular shape so that the bone screw 19 can be inserted or pulled out longitudinally with its profile piece 21 (FIG. 3).
  • a fixing rod 25 which is composed of the telescopic pieces 26 and 27.
  • the two parts are fixed in that the insertable part 26 has fixing notches 28.
  • the other sleeve-shaped telescopic piece 27 can be fixed with the insertable part in that the sleeve-shaped telescopic piece is pressed in the region of the fixing notches with the aid of special pliers, so that they are squeezed together.
  • a perforated template can be used as an aid, which is designed, for example, as a U-rail piece and has holes at the same distance as the fixing notches are attached (FIGS. 4 and 5).
  • the fixing rod has a grid plate 29 with a bore at the end, which engages with the grid 22 of the profile piece 21 when both parts are connected by a screw 30 (cf. FIG. 5).
  • the screw has a hole 31 in the center, into which a pin is inserted, which has a handle (not shown). This makes it easier to insert the screw, so to speak, on the handle using the pin into the thread.
  • a one-piece fixing rod with grid plates at the end with a bore can also be used. If it is necessary to adjust the grid plates that are normally in one plane, this can be done by simply rotating the grid plate around the longitudinal axis of the fixing rod.
  • FIGS. 6 and 7 Another embodiment of the extension rod or bone screw is shown in FIGS. 6 and 7.
  • the bone screw 19 has a cylindrical roller piece 32, onto which a correspondingly designed fork piece 33 can be pushed, to which the extension rod 17b connects.
  • the end face of the roller piece 32 has grids 34 for receiving the fixing rod, as already described. So that the roller piece 32 is non-rotatably supported in the fork piece 33, a shoulder 35 is attached to the roller piece, which engages in a corresponding recess 36 in the fork piece.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

A device for adjusting a vertebral column with damaged vertebrae comprises an adjustable arm on a guiding axis and a stationary arm attached to the guiding axis, each arm having a hollow receiving body adjustable in two planes for a lengthening rod, which can be connected with a tirefond. Each arm (2, 4) has an intermediate jointed piece (5, 5a) with an intermediate jointed piece (5, 5a) with two joints (6, 7), each intermediate jointed piece (5, 5a) being connected in a hinged manner to a support (8) for the hollow receiving body with is designed as an attachable cylindrical piece (15) with a tangential drilled hole (16).

Description

Die Erfindung betrifft eine Vorrichtung zum Einrichten einer Wirbelsäule mit geschädigten Wirbelkörpern, bestehend aus einem auf einer Führungsachse verstellbaren Arm und einem darauf angeordneten festen Arm, wobei jeder Arm einen in zwei Ebenen verstellbaren Aufnahmehohlkörper für eine Verlängerungsstange trägt, die mit einer Knochenschraube verbindbar ist.The invention relates to a device for setting up a spine with damaged vertebral bodies, consisting of an arm adjustable on a guide axis and a fixed arm arranged thereon, each arm carrying a hollow body, adjustable in two planes, for an extension rod, which can be connected with a bone screw.

Eine derartige Vorrichtung ist aus der EP-A-0159007 bekannt. Bei der bekannten Vorrichtung sind die auf der Führungsachse angeordneten Arme räumlich gekrümmt tragen und endseitig gelenkig angebrachte Gewindezapfen, auf denen eine Aufnahmehülse drehbar und mit Hilfe einer Flügelmutter feststellbar ist.Such a device is known from EP-A-0159007. In the known device, the arms arranged on the guide axis are spatially curved, and at the end they are articulated threaded pins, on which a receiving sleeve can be rotated and locked with the aid of a wing nut.

Die Ausführung der Einrichtung in dieser Art, insbesondere die Anordnung der Aufnahmehülse und deren Befestigung, entspricht jedoch nicht den Anforderungen, die ein Operateur, insbesondere im Hinblick auf eine leichte Handhabbarkeit, an ein solches Gerät stellen muß.However, the design of the device in this way, in particular the arrangement of the receiving sleeve and its attachment, does not meet the requirements that an operator must place on such a device, particularly with regard to easy handling.

Der Erfindung liegt daher die Aufgabe zugrunde, die Vorrichtung zur Einrichtung einer Wirbelsäule mit geschädigten Wirbelkörpern so zu verbessern, daß eine leichtere Handhabung erreicht ist.The invention is therefore based on the object of improving the device for setting up a spine with damaged vertebral bodies in such a way that easier handling is achieved.

Nach der Erfindung wird das dadurch erreicht, daß jeder Arm ein Zwischengelenkstück mit zwei Gelenken trägt, wobei am Zwischengelenkstück ein Träger für den Aufnahmehohlkörper angelenkt ist, der als fixierbares Zylinderstück mit einer Bohrung ausgebilfet ist, die im radialen Abstand u.senkrecht zur Zylinderstück-Längsachsenebene angeordnet ist. Dabei ist als Ausgestaltung der Erfindung spitzwinklig zur Bohrung eine Fixierschraube zur Fixierung des Verlängerungsstabes vorgesehen. Das Zylinderstück ist in weiterer Ausgestaltung axial verstellbar und in einer Endlage feststellbar.According to the invention this is achieved in that each arm carries an intermediate joint piece with two joints, wherein a support for the receiving hollow body is articulated on the intermediate joint piece, which is designed as a fixable cylinder piece with a bore that is at a radial distance and perpendicular to the cylinder piece longitudinal axis plane is arranged. As an embodiment of the invention, a fixing screw for fixing the extension rod is provided at an acute angle to the bore. In a further embodiment, the cylinder piece is axially adjustable and lockable in one end position.

Gemäß einer besonders vorteilhaften Ausführungsform trägt zu diesem Zweck der Träger einen senkrechten Gewindezapfen, der an einem Ende eine Rasterplatte und in Abstand davon eine auf dem Gewinde drehbare Mutter aufweist, wobei zwischen der Mutter und der Rasterplatte der Aufnahmehohlkörper drehbar und axial verstellbar angebracht ist.According to a particularly advantageous embodiment, for this purpose the carrier carries a vertical threaded pin which has a grid plate at one end and a nut rotatable on the thread at a distance therefrom, the hollow receptacle body being rotatably and axially adjustable between the nut and the grid plate.

Durch diese Gestaltung kann die Verlängerungsstange leichter und zugänglicher in den Aufnahmehohlkörper eingebracht und fixiert werden, indem das Zylinderstück mittels der Mutter axial verschoben wird, wobei die Rasterplatte erfaßt wird, so daß einerseits die Rasten der Rasterplatte als auch andererseits die Rasten des Zylinderstückes in Eingriff sind. Hinzu kommt, daß die Fixierschraube zur Feststellung der Verlängerungsstange durch ihre schräge Lage vom Operateur leichter bedienbar ist. Darüber hinaus kann die gesamte Vorrichtung durch die Anordnung der Zwischengelenkstücke leichter eingerichtet werden.With this design, the extension rod can be inserted and fixed more easily and more easily in the receiving hollow body by axially displacing the cylinder piece by means of the nut, the grid plate being gripped so that on the one hand the catches of the grid plate and on the other hand the catches of the cylinder piece are engaged . In addition, the fixing screw for fixing the extension rod is easier to operate by the surgeon due to its inclined position. In addition, the arrangement of the intermediate joint pieces makes it easier to set up the entire device.

Eine weitere Verbesserung der Handhabung der Vorrichtung wird dadurch erreicht, daß die Verlängerungsstange endseitig eine wannenförmige Ausbildung für die Aufnahme der Knochenschraube aufweist, die kopfseitig ein entsprechend gestaltetes Profilstück mit Rasterung für die Aufnahme eines Fixierstabes besitzt. Die wannenförmige Ausbildung weist dabei mehr als Halbkreisform auf, so daß die Verlängerungsstange nur axial herausziehbar ist.A further improvement in the handling of the device is achieved in that the extension rod has at the end a trough-shaped design for receiving the bone screw, which has a correspondingly designed profile piece with a grid for receiving a fixing rod on the head side. The trough-shaped design has more than a semicircular shape, so that the extension rod can only be pulled out axially.

Dadurch ist auf einfache Weise das Aufsetzen des Verlängerungsstabes auf die Knochenschraube ermöglicht, weil lediglich durch Aufschieben des wannenförmigen Teiles auf das entsprechende Profilstück die Verbindung ermöglicht wird.This allows the extension rod to be placed on the bone screw in a simple manner, because the connection is made possible only by sliding the trough-shaped part onto the corresponding profile piece.

Auch dabei erfolgt die Befestigung der Knochenschraube in der wannenförmigen Ausbildung durch eine Schraube, die spitzwinklig zur Achse der Verlängerungsstange einschraubbar ist, so daß auch hier der Operateur das Gerät leichter handhaben kann.In this case, too, the bone screw in the trough-shaped configuration is fastened by a screw which can be screwed in at an acute angle to the axis of the extension rod, so that here too the operator can handle the device more easily.

Eine andere Ausführungsform der Verbindung der Knochenschraube mit der Verlängerungsstange kann darin bestehen, daß an der Knochenschraube ein zylinderförmiges Walzenstück angeordnet ist, das stirnseitig eine Rasterung für die Aufnahme eines Fixierstabes aufweist, wobei dann die Verlängerungsstange endseitig ein der Zylinderform entsprechendes Gabelstück besitzt, damit diese Verlängerungsstange auf das Walzenstück aufschiebbar ist. Dabei ist die Verlängerungsstange mit dem Walzenstück drehfest verbunden, beispielsweise dadurch, daß an dem Walzenstück ein Aufsatz angebracht ist, der in eine entsprechende Aussparung in dem Gabelstück der Verlängerungsstange eingreift.Another embodiment of the connection of the bone screw with the extension rod can consist in that a cylindrical roller piece is arranged on the bone screw, which has a raster for receiving a fixing rod at the end, the extension rod then having a fork piece corresponding to the cylinder shape at the end, so that this extension rod can be pushed onto the roller piece. The extension rod is rotatably connected to the roller piece, for example, in that an attachment is attached to the roller piece, which engages in a corresponding recess in the fork piece of the extension rod.

Eine besonders zweckmäßige Ausbildung des Fixierstabes besteht darin, daß der Fixierstab aus Teleskopstücken gebildet wird, dessen einschiebbarer Teil Fixierkerben aufweist, wobei auch dieser Fixierstab endseitig eine Rasterplatte mit Bohrung besitzt.A particularly expedient embodiment of the fixing rod consists in that the fixing rod is formed from telescopic pieces, the insertable part of which has fixing notches, this fixing rod also having a grid plate with a bore at the end.

Dieser Fixierstab dient bekanntlich dazu, die mit Hilfe der Einrichtung eingerichteten Wirbelkörper in der eingerichteten Lage zu fixieren, so daß die geschädigte Wirbelstelle durch den Fixierstab überbrückt ist. Die Länge des Fixierstabes und auch die relative Lage der endseitigen Rasterplatten zueinander wird dann in der Weise fixiert, daß mit Hilfe einer Lochschablone das äußere Teleskopstück mit Hilfe einer entsprechend ausgebildeten Zange kerbförmig eingedrückt wird, wobei dann diese Kerbe genau in der Kerbe des einschiebbaren Teleskopstückes liegt.As is known, this fixing rod serves to fix the vertebral bodies that have been set up with the aid of the device, so that the damaged vertebral area is bridged by the fixing rod. The length of the fixing rod and also the relative position of the end grid plates to each other is then fixed in such a way that the outer telescopic piece is pressed in with the aid of a perforated template with the aid of appropriately trained pliers, this notch then lying exactly in the notch of the telescopic piece that can be inserted .

Für kurze überbrückungslängen ist ein aus einem Stück bestehender Fixierstab mit endseitiger Rasterplatte mit Bohrung vorgesehen.For short bridging lengths, a one-piece fixing rod with a grid plate at the end with a hole is provided.

In der Zeichnung ist eine beispielsweise Ausführungsform dargestellt.

  • Fig. 1 zeigt die Vorrichtung in Aufsicht;
  • Fig. 2 ist ein Schnitt gemäß der Linie II-II durch das Zylinderstück;
  • Fig. 3 ist ein Schnitt gemäß der Linie III-III durch die Verlängerungsstange;
  • Fig. 4 zeigt die Fixierung der Knochenschrauben mit Hilfe eines Fixierstabes;
  • Fig. 5 zeigt einen Schnitt gemäß der Linie V-V in Fig. 4;
  • Fig. 6 und 7 zeigen eine andere Ausbildung von Knochenschrauben und Verlängerungsstange.
An example embodiment is shown in the drawing.
  • Fig. 1 shows the device in supervision;
  • Fig. 2 is a section along the line II-II through the cylinder piece;
  • Fig. 3 is a section along the line III-III through the extension rod;
  • Fig. 4 shows the fixation of the bone screws with the help of a fixing rod;
  • Fig. 5 shows a section along the line VV in Fig. 4;
  • 6 and 7 show another embodiment of bone screws and extension rod.

Die Vorrichtung zum Einrichten einer Wirbelsäule besteht aus der Führungsachse 1 und dem daran fest angeordneten Arm 2 und dem mit Hilfe einer Gewindespindel 3 verschiebbar bzw. verstellbar angeordneten Arm 4. Jeder Arm 2 bzw. 4 trägt ein Zwischengelenkstück 5 bzw. 5a mit den Gelenkachsen 6 und 7. An dem Zwischengelenkstück 5 bzw. 5a ist ein Träger 8 bzw. 8a angelenkt, der den insgesamt mit 9 bezeichneten Aufnahmehohlkörper 9 trägt. Die Verstellebene des Aufnahmehohlkörpers steht senkrecht zu der Verstellebene des Trägers 8 bzw. 8a.The device for setting up a spine consists of the guide axis 1 and the arm 2 fixedly arranged thereon and the arm 4 which can be moved or adjusted with the aid of a threaded spindle 3. Each arm 2 or 4 carries an intermediate joint piece 5 or 5a with the joint axes 6 and 7. A carrier 8 or 8a is articulated to the intermediate joint piece 5 or 5a, which carries the receiving hollow body 9, which is designated overall by 9. The adjustment plane of the receiving hollow body is perpendicular to the adjustment plane of the carrier 8 or 8a.

Die Ausbildung des Aufnahmehohlkörpers 9 ist in Fig. 2 im einzelnen dargestellt. Dabei ist an dem Arm 8 fest ein senkrechter Gewindezapfen 10 angeordnet, der im unteren Teil das Gewinde 11 trägt.The design of the receiving hollow body 9 is shown in detail in FIG. 2. In this case, a vertical threaded pin 10 is arranged on the arm 8, which carries the thread 11 in the lower part.

Am einen Ende des Gewindezapfens ist die Rasterplatte 12 fest angeordnet, welche die Rasten 13 besitzt. Am unteren Ende des Gewindezapfens, also auf dem Gewinde 11, ist die Mutter 14 angeordnet. Daraus wird deutlich, daß der als Zylinderstück 15 ausgebildete Aufnahmehohlkörper, welcher die im radialen Abstand und senkrecht zur Zylinderstück-Längsachsenebene angeordnete Bohrung 16 besitzt, axial verstellbar und in einer Endlage fixierbar ist. Wird nämlich an der Mutter 14 gedreht, dann bewegt sich das Zylinderstück 15 zur Rasterplatte hin, wobei die Rasten einerseits an der Rasterplatte, nämlich die Rasten 13 mit den Rasten 13a am Zylinderstück, in Eingriff kommen.The grid plate 12, which has the catches 13, is fixedly arranged at one end of the threaded pin. At the lower end of the threaded pin, ie on the thread 11, the nut 14 is arranged. It is clear from this that the receiving hollow body designed as a cylinder piece 15, which has the bore 16 arranged at a radial distance and perpendicular to the longitudinal axis plane of the cylinder piece, is axially adjustable and fixable in an end position. If the nut 14 is rotated, then the cylinder piece 15 moves towards the grid plate, the catches on the one hand on the grid plate, namely the catches 13 engaging with the catches 13a on the cylinder piece.

Die Bohrung 16 nimmt die Verlängerungsstange 17 auf. Die Befestigung der Verlängerungsstange 17 geschieht mit Hilfe einer Fixierschraube 18, die spitzwinklig zu der Tangentialbohrung 16 angeordnet ist. Durch diese Ausbildung des Aufnahmehohlkörpers als fixierbares Zylinderstück mit Tangentialbohrung ist die Handhabung des Gerätes einfacher, weil die einzusetzenden Teile und die festzustellenden Teile leicht zugänglich sind.The bore 16 receives the extension rod 17. The extension rod 17 is fastened with the aid of a fixing screw 18, which is arranged at an acute angle to the tangential bore 16. This design of the receiving hollow body as a fixable cylinder piece with a tangential bore makes the device easier to use because the parts to be used and the parts to be locked are easily accessible.

Hinzukommt, daß durch das Zwischengelenkstück 5 bzw. 5a und die Verstellbarkeit des Zylinderstücks auf dem Gewindezapfen 10 jede beliebige Lage des Verlängerungsstückes einstellbar ist, wodurch auch die auf der Knochenschraube 19 aufgesetzten Verlängerungsstäbe 17, 17a entsprechend eingerichtet werden können, was eine entsprechende Einrichtung der in die gesunden Wirbelkörper eingeschraubten Knochenschrauben bewerkstelligt.In addition, any position of the extension piece can be adjusted by the intermediate joint piece 5 or 5a and the adjustability of the cylinder piece on the threaded pin 10, as a result of which the extension rods 17, 17a placed on the bone screw 19 can also be set up accordingly, which means that the device in FIG the healthy vertebrae screwed in.

Auch die besondere Ausbildung der Verlängerungsstange und der dazugehörigen Knochenschraube stellen eine Verbesserung hinsichtlich der Handhabung des Gerätes durch den Operateur dar.The special design of the extension rod and the associated bone screw also represent an improvement in the handling of the device by the surgeon.

Dies wird dadurch erreicht, daß die Verlängerungsstange endseitig eine wannenförmige Ausbildung 20 aufweist, die von der Knochenschraube 19 aufgenommen wird. Dabei hat die Knochenschraube kopfseitig ein entsprechend gestaltetes Profilstück 21 mit einer an der Oberseite angeordneten Rasterung 22. Die Befestigung des Profilstückes 21 in der wannenförmigen Ausbildung 20 erfolgt ebenfalls mit einer Schraube 23, welche spitzwinklig zur Achse der Verlängerungsstange 17 verläuft (Fig. 1).This is achieved in that the extension rod has a trough-shaped design 20 at the end, which is received by the bone screw 19. The bone screw has a correspondingly designed profile piece 21 on the head side with a raster 22 arranged on the top. The profile piece 21 is also fastened in the trough-shaped configuration 20 with a screw 23, which runs at an acute angle to the axis of the extension rod 17 (FIG. 1).

Die wannenförmige Ausbildung 20 weist dabei mehr als Halbkreisform auf, damit die Knochenschraube 19 mit ihrem Profilstück 21 längs eingeschoben werden kann bzw. längs herausgezogen werden kann (Fig. 3).The trough-shaped design 20 has more than a semicircular shape so that the bone screw 19 can be inserted or pulled out longitudinally with its profile piece 21 (FIG. 3).

Sind die Wirbel 24 mit Hilfe dieser Vorrichtung eingerichtet, dann muß diese Lage fixiert werden. Das geschieht mit Hilfe eines Fixierstabes 25, der aus den Teleskopstücken 26 und 27 zusammengesetzt ist. Die Fixierung der beiden Teile geschieht dadurch, daß der einschiebbare Teil 26 Fixierkerben 28 besitzt. Dadurch kann das andere hülsenförmige Teleskopstück 27 mit dem einschiebbaren Teil dadurch fixiert werden, daß mit Hilfe einer besonderen Zange auf das hülsenförmige Teleskopstück im Bereich der Fixierkerben gedrückt wird, so daß ein Zusammenquetschen erfolgt. Dabei kann eine Lochschablone als Hilfsmittel dienen, die beispielsweise als U-Schienenstück ausgebildet ist und in gleichem Abstand Bohrungen aufweist, wie die Fixierkerben angebracht sind (Fig. 4 und 5).If the vertebrae 24 are set up with the aid of this device, then this position must be fixed. This is done with the help of a fixing rod 25, which is composed of the telescopic pieces 26 and 27. The two parts are fixed in that the insertable part 26 has fixing notches 28. As a result, the other sleeve-shaped telescopic piece 27 can be fixed with the insertable part in that the sleeve-shaped telescopic piece is pressed in the region of the fixing notches with the aid of special pliers, so that they are squeezed together. In this case, a perforated template can be used as an aid, which is designed, for example, as a U-rail piece and has holes at the same distance as the fixing notches are attached (FIGS. 4 and 5).

Der Fixierstab weist endseitig eine mit Bohrung versehene Rasterplatte 29 auf, die mit der Rasterung 22 des Profilstückes 21 in Eingriff kommt, wenn beide Teile durch eine Schraube 30 verbunden werden (vergl. Fig. 5).The fixing rod has a grid plate 29 with a bore at the end, which engages with the grid 22 of the profile piece 21 when both parts are connected by a screw 30 (cf. FIG. 5).

Damit das Einsetzen der Schraube 30 erleichtert ist, besitzt die Schraube mittig eine Bohrung 31, in die ein Zapfen eigesetzt wird, welcher ein Griffstück besitzt (nicht dargestellt). Dadurch kann die sozusagen an dem Griffstück mit Hilfe des Zapfens sitzende Schraube leichter in das Gewinde eingeführt werden.So that the insertion of the screw 30 is facilitated, the screw has a hole 31 in the center, into which a pin is inserted, which has a handle (not shown). This makes it easier to insert the screw, so to speak, on the handle using the pin into the thread.

Ist der Fixierstab 25 an Ort und Stelle gebracht, dann ist die Operation abgeschlossen, so daß nunmehr die Vorrichtung zusammen mit den Verlängerungsstangen 17 bzw. 17a abgenommen werden kann.If the fixing rod 25 is brought in place, the operation is completed, so that the device can now be removed together with the extension rods 17 and 17a.

Bei kurzen überbrückungslängen kann auch ein einstückiger Fixierstab mit endseitigen Rasterplatten mit Bohrung verwendet werden. Ist ein Verstellen der normalerweise in einer Ebene liegenden Rasterplatten erforderlich, dann kann das durch einfaches Verdrehen der Rasterplatte um die Längsachse des Fixierstabes geschehen.In the case of short bridging lengths, a one-piece fixing rod with grid plates at the end with a bore can also be used. If it is necessary to adjust the grid plates that are normally in one plane, this can be done by simply rotating the grid plate around the longitudinal axis of the fixing rod.

Eine andere Ausbildung der Verlängerungsstange bzw. Knochenschraube ist in Fig. 6 und 7 dargestellt. Dabei besitzt die Knochenschraube 19 ein zylinderförmiges Walzenstück 32, auf das ein entsprechend ausgebildetes Gabelstück 33 aufschiebbar ist, an das sich die Verlängerungsstange 17b anschließt. Die Stirnseite des Walzenstückes 32 besitzt Rasterungen 34 zur Aufnahme des Fixierstabes, wie bereits beschrieben. Damit das Walzenstück 32 undrehbar im Gabelstück 33 lagert, ist ein Ansatz 35 am Walzenstück angebracht, der in eine entsprechende Aussparung 36 im Gabelstück eingreift.Another embodiment of the extension rod or bone screw is shown in FIGS. 6 and 7. The bone screw 19 has a cylindrical roller piece 32, onto which a correspondingly designed fork piece 33 can be pushed, to which the extension rod 17b connects. The end face of the roller piece 32 has grids 34 for receiving the fixing rod, as already described. So that the roller piece 32 is non-rotatably supported in the fork piece 33, a shoulder 35 is attached to the roller piece, which engages in a corresponding recess 36 in the fork piece.

Claims (12)

1. Device for setting a spinal column with damaged vertebrae and consisting of an arm (4), which is adjustable on a guide axle (1), and a fixed arm (2) arranged thereon, wherein each arm (2, 4) carries a hollow receiving body (9), which is adjustable in two planes, for an extension rod (17, 17a, 17b), which is connectable with a bone screw (19), characterised thereby, that each arm (2, 4) carries a respective intermediate hinge member (5, 5a) each with two hinges (6, 7), wherein a carrier (8) for the hollow receiving body (9), which is constructed as fixable cylindrical member (15) with a bore (16), which is arranged at a radial spacing from and perpendicularly to the longitudinal axial plane of the cylindrical member, is articulated at the intermediate hinge member (5, 5a).
2. Device according to claim 1, characterised thereby, that the cylindrical member (15) is adjustable axially and fixable in an end position.
3. Device according to claim 1, characterised thereby, that a fixing screw (18) for fixing the extension rod (17, 17a) is provided at an acute angle to the tangential bore (16).
4. Device according to claim 1 and 2, characterised thereby, that the carrier (8) carries a perpendicular threaded spigot (10), which displays a nut (14) and a fixedly located raster plate (12), wherein the hollow receiving body is mounted to be rotatable and axially displaceable between the nut (14) and the raster plate (12).
5. Device according to claim 1, characterised thereby, that the extension rod (17, 17a) at the end displays a trough-shaped formation (20) for the reception of the bone screw (19), which at the head end displays a correspondingly structured profile member (21) with rastering (22) for the reception of a fixing rod (25).
6. Device according to claim 4, characterised thereby, that the trough-shaped formation (20) displays more than semicircular shape so that the extension rod is withdrawable only axially.
7. Device according to claim 4, characterised thereby, that the fastening of the bone screw (19) in the trough-shaped formation (20) of the extension rod (17, 17a) takes place by a screw (23), which is able to be screwed in at an acute angle to the axis of the extension rod.
8. Device according to claim 1, characterised thereby, that the bone screw displays a cylindrical roll member (32), which at an end face displays a rastering (34) for the reception of a fixing rod and that the extension rod at the end displays a fork member (33) corresponding with the cylindrical shape, wherein the extension rod is mounted on the roll member to be secure against rotation.
9. Device according to claim 5, characterised thereby, that the fixing rod (25) consists of telescopic members (26, 27), the insert part (26) displays fixing notches (28).
10. Device according to claim 5, characterised thereby, that the fixing rod is constructed in one piece.
11. Device according to claim 9 and 10, characterised thereby, that the fixing rod at one end displays a raster plate (29) with bore.
12. Device according to claim 5, characterised thereby, that the connection of the fixing rod with the bone screw takes place through a screw (30), which centrally displays a depression (31) for the insertion of a retaining pin with handle.
EP88902804A 1987-04-02 1988-03-31 Device for adjusting a vertebral column Expired - Lifetime EP0316371B1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE3711091 1987-04-01
DE19873711091 DE3711091A1 (en) 1987-04-02 1987-04-02 DEVICE FOR SETTING UP A SPINE WITH A DAMAGED SPINE
DE8704901U DE8704901U1 (en) 1987-04-02 1987-04-02 Device for setting up a spine with damaged vertebral bodies

Publications (2)

Publication Number Publication Date
EP0316371A1 EP0316371A1 (en) 1989-05-24
EP0316371B1 true EP0316371B1 (en) 1991-10-30

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EP88902804A Expired - Lifetime EP0316371B1 (en) 1987-04-02 1988-03-31 Device for adjusting a vertebral column

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US (1) US4957495A (en)
EP (1) EP0316371B1 (en)
DE (2) DE8704901U1 (en)
WO (1) WO1988007357A1 (en)

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EP0316371A1 (en) 1989-05-24
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DE8704901U1 (en) 1987-07-23
DE3711091A1 (en) 1988-10-13
US4957495A (en) 1990-09-18

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